Hospital Helps Tiny Babies Beat Huge Odds

LONG BEACH — On the day after she was born, Elizabeth Kathleen Truman was baptized. Her parents were afraid she might die if they waited any longer.

The baby had come into the world on April 26, three-and-a-half months early, weighing less than 2 pounds, barely the bulk of a box of chocolates. Her mother remembers sitting next to her transparent Isolette day after day, hours at a time, impervious to the doctors and nurses bustling about the newborn intensive care unit. She was too captivated by the fragile nature of her first and only child.

"They tell you that premature babies are small, but you don't realize how small they are," said Marcy Truman. "They're like dolls, they're like little dolls."

That was 15 weeks ago. Today Elizabeth's weight has more than doubled to "an enormous 5 pounds, 2 ounces," her mother said, laughing at the Truman home in Mission Viejo. But that is still less than what most full-term babies--with about 36 weeks in the womb--weigh at birth. Her tiny eyes, a delicate blend of green and brown, continue to be threatened by a disease that could take her sight. But everyone is optimistic that this danger, like countless others she has encountered, eventually will pass.

So far, Elizabeth Truman has beaten the odds that say underweight babies are 40 times more likely to die in their first month than a normal infant. However, she remains five times more likely to die before the end of her first year. Her mother is convinced that the infant has made it this far because of Memorial Medical Center of Long Beach.

According to some recent state figures, she may be right. For the fifth year in a row--since researchers at the University of California, Santa Barbara, began compiling such data--Memorial has recorded the state's lowest so-called perinatal mortality rate. It is not a measure of how many babies die each year at Memorial or any of the state's 349 other active maternity hospitals. Rather, it is an intricate, and occasionally imperfect, statistic that balances a hospital's death rate for newborns against what might normally be expected given the severity of cases typically handled.

The perinatal period, stretching from the last 20 weeks of a mother's pregnancy through the first 28 days of her newborn's life, is the time in which "medical intervention" can carry the most impact, explains statistician Ciaran S. Phibbs, who works out of UC San Diego. The mortality rate for the perinatal period is the best available standard by which a hospital can judge the effectiveness of its newborn care.

Out of about 5,000 Memorial births last year, 94 newborns died--in cold numbers about double the average for the rest of California. But when you consider that 35% to 40% of those births came after problem pregnancies, medical experts agree, the hospital's success rate is almost astounding.

The fact that Memorial should fare so well is not really surprising, experts say. The giant $267-million complex, which towers over Atlantic Avenue at 28th Street, has both a women's hospital and a children's hospital widely recognized as among the most advanced in the state.

By its number of licensed beds, Memorial has the state's largest perinatal center and the largest newborn intensive care unit, treating up to 54 high-risk infants each day. It has the largest educational outreach program, where medical information is shared among doctors at 20 hospitals as close as four blocks and as far as 30 miles away. And it has the largest maternal transfer program, through which more than 30 surrounding hospitals refer problem cases. Its Life Flight helicopter ambulances were used 600 times last year to transport expectant mothers.

There are innovative programs from laser technology to in vitro fertilization, the process that produces what most people think of as test-tube babies. A few weeks before Marcy Truman had her daughter, for example, Memorial was the birthplace of the nation's first test-tube quadruplets, born to the Kuzmanic family of San Pedro. All weighed less than 2 pounds at birth and have been released in good condition, hospital officials said.

"I think we give very good care here," said Dr. Roger K. Freeman, medical director of the women's hospital at Memorial. "But a lot of places give very good care, in my opinion."

Abundance of Hospitals

The Long Beach area, as well as all of Los Angeles and Orange counties, enjoys an abundance of hospitals that are well-equipped and staffed. In the state perinatal mortality research, for example, high marks also were registered by Cedars-Sinai Medical Center and White Memorial Medical Center in Los Angeles, UC Irvine Medical Center and the Kaiser Permanente hospital in Bellflower. (The state figures combine data from 1978 to 1982, the most recent year in which certain statistics are available.)